1. Technical Field
The present disclosure relates to surgical instruments and, more specifically, to energy-based surgical instruments including integrated nerve detection systems.
2. Discussion of Related Art
Energy-based surgical instruments apply energy, e.g., RF, microwave, light, ultrasonic, optical, thermal, etc., to tissue to treat tissue during a surgical procedure. Such surgical instruments are typically used in conjunction with a surgical generator that produces an electromagnetic wave, typically above 100 kilohertz, for application to tissue. The electromagnetic wave dissipates energy as heat as it travels through tissue. Electromagnetic frequencies above 100 kilohertz are employed to avoid muscle and/or nerve stimulation. Controlling the duration and intensity of energy application can be used for treating tissue in various manners such as, for example, cutting, dissecting, ablating, arresting blood loss, sealing, coagulating, etc.
During the application of energy to tissue, the heating of tissue can cause damage to nerves in close proximity to the tissue being heated. Although electrical nerve stimulation has been used to detect nerves in close proximity to tissue being treated, electrical nerve stimulation is limited by the need for physical contact between the electrode and nerve-containing tissue, while the spatial precision of the stimulation is limited by the size of the electrode. Electrical nerve stimulation may also produce artifacts that may interfere with the measurement.
Optical nerve stimulation is an alternative to electrical nerve stimulation. A general discussion of optical nerve stimulation can be found in Nathaniel M. Fried et al., Identification and Imaging of Nerves Responsible for Erectile Function in Rat Prostate, In Vivo, Using Optical Nerve Stimulation and Optical Coherence Tomography, 13 IEEE J. OF SELECTED TOPICS IN QUANTUM ELECTRONICS 1641, 1642 (2007).